Greater Sydney Area HEMS

NOVEMBER 4, 2023

Focus On: Burns Our burns videos are now collected together in a handy vimeo showcase! Follow this link to see all our burns-related airway videos: [link] These two videos come from the same patient, who had life-threatening burns. This patient was intubated as part of resuscitation after drowning.

Airway Management 144

Airway Management Burns Operations Resuscitation 144

Don't Forget the Bubbles

OCTOBER 7, 2024

Up to 5% of burns occur secondary to electrical injuries, and this rises to 27% in developing countries. Significant injuries can occur even in the absence of extensive burns or other signs of external injury. Children, especially toddlers, may insert objects into outlets, leading to shocks or burns.

Burns 80

Burns Fluid Resuscitation Shock Resuscitation 80

RebelEM

APRIL 29, 2024

Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. This can often lead to significant delays in proper resuscitation. Studies reviewed landmark-based CVC compared to IO; using IJ, subclavian, and femoral CVC sites.

Resuscitation 105

Resuscitation Administration Emergency Department Ultrasounds 105

RebelEM

JUNE 7, 2023

In that population, it is essential to recognize that the absence of oropharyngeal lesions/burns cannot exclude the presence of gastrointestinal injury internally. General resuscitation with broad spectrum antibiotics and volume resuscitation if the patient appears to be septic. References Hoffman RS, Burns MM, Gosselin S.

Poisoning 96

Poisoning Burns Resuscitation Pediatrics 96

RebelEM

MAY 29, 2023

Judicious fluid resuscitation is indicated in patients with signs of hypo perfusion but is often inadequate necessitating the administration of vasoactive medications. At the most severe end, this includes endothelial dysfunction leading to increased vascular permeability, abnormal nitric oxide metabolism, and vasodilation (i.e. 95% CI 15.4

Shock 145

Shock Fluid Resuscitation Sepsis Resuscitation 145

University of Maryland CC Project

MARCH 7, 2022

Edward Hebert School of Medicine at the Uniformed Services University of the Health Sciences presents on Environmental Injuries including burns, electrical, altitude and heat stroke. Dr. Kevin Chung, Professor and Chair of the Department of Medicine, and professor of Surgery, at the F.

Burns 40

Burns Stroke Airway Management Resuscitation 40

Taming the SRU

DECEMBER 17, 2024

Fluid management in the Emergency Department (ED) is crucial in the adequate resuscitation of the acutely ill and decompensating patient. Patients present to the ED with hypovolemia secondary to a plethora of causessome requiring IV fluid resuscitation and others requiring none.

Dehydration 82

Dehydration Fluid Resuscitation Administration Resuscitation 82

Northwestern EM Blog

MAY 2, 2022

More modest lactic acid elevations are less likely to be related to cyanide poisoning and should not prompt intervention, especially in an asymptomatic patient, unless the level is persistently elevated despite adequate resuscitation.

Burns 52

Burns Poisoning EKG/ECG Operations 52

Taming the SRU

FEBRUARY 7, 2024

Vaughan SJS/TEN and DRESS are life-threatening drug reactions that require immediate discontinuation of the drug and specialist involvement In SJS/TEN, if >10% skin involvement or worsening symptoms, transfer the patient to a Burn Center DRESS has characteristic multi organ involvement, so a high level of suspicion for complications should be maintained (..)

Administration 97

Administration PPE Ultrasounds Poisoning 97

Emergency Medicine Cases

JUNE 4, 2019

Electrical injuries are rare, representing less than 1% of burn center admissions. So there is a paucity of robust evidence for the management of these patients.

Fluid Resuscitation 52

Fluid Resuscitation Burns Resuscitation EMS 52

Intensive Blog

AUGUST 21, 2024

Outline the initial assessment of severe burns injury, including how you will calculate fluid resuscitation requirements. Discuss the advantages and disadvantages of using pulse oximetry to target oxygen therapy (50%) What SpO2 targets do you use in ICU patients and why? (50%) 50%) Oxygen saturation targets in critical care Q2.

Burns 52

Burns Fluid Resuscitation Hyperthermia / Hypothermia Operations 52

Taming the SRU

SEPTEMBER 15, 2023

ETT onto a fiberoptic scope.

CPR 88

CPR Burns Airway Management Wellness 88

Taming the SRU

MAY 11, 2024

Be careful with fluid resuscitation in renal transplant patients who can be at risk for volume overload. Validity Evidence for a Team-Leading Assessment Tool in Pediatric Emergency Resuscitation Using Video Review (Hartwell et al.) Assessed and provided feedback of pediatric resuscitations based on video review.

Administration 91

Administration Resuscitation Fluid Resuscitation Research 91

Taming the SRU

APRIL 11, 2024

Correct pronunciation and understanding of personal narratives is important. There is history behind a person’s name which often has deep and personal meaning. Offer people tips and guidance on pronunciation. ETT adapter directly into angiocath 3 mL syringe + 7.0 ETT adapter into syringe 10 mL syringe + 7.0 Fr < 2.5

Ultrasounds 93

Ultrasounds Pediatrics Hyperthermia / Hypothermia Burns 93

ACEP Now

MARCH 14, 2024

Per EMS, the patient was found at the bottom of a high voltage line with diffuse burns and amputation of his left forearm. FIGURE 1: Electrical burns of the patient’s bilateral feet. FIGURE 2: Traumatic amputation and electrical burn of the patient’s left arm. He was intubated by EMS due to the extent of his injuries.

Burns 52

Burns Fluid Resuscitation EKG/ECG EMS 52

EMDocs

AUGUST 17, 2023

Additionally, 80% of patients in the control group required open label NE use indicating that NE was going to be needed in most of these patients regardless of initial resuscitation method. I will continue to reach for pressors early in resuscitation of the septic shock patient. vs 48.4% (OR 3.4, vs 48.4% (OR 3.4, A Randomized Trial.

Sepsis 67

Sepsis Shock Resuscitation Fluid Resuscitation 67

PHEM Cast

JANUARY 4, 2017

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. Boet S, Bould MD, Layat Burn C, Reeves S. Scenario based outdoor simulation in pre-hospital trauma care using a simple mannequin model. Patterson MD, Geis GL, Falcone RA, LeMaster T, Wears RL. BMJ Quality & Safety. 2013; 22: 468-477.

Teamwork 52

Teamwork Burns Emergency Department Resuscitation 52

Taming the SRU

NOVEMBER 4, 2023

Yates Foot Infection NSTIs are rare but deadly pathology that need to be considered with any soft tissue infection NSTI is a clinical diagnosis, but there are many imaging and laboratory assessments to help increase clinical suspicion Expedited disposition to the OR for NSTIs under 12 hours from ED presentation significantly decreases mortality Emesis (..)

Hyperthermia / Hypothermia 83

Hyperthermia / Hypothermia Resuscitation Burns Emergency Department 83

Taming the SRU

JUNE 24, 2024

Skin burns and irritation can also result from the pacing pads and cause pain. Resuscitation , Volume 181,2022,Pages 140-146,ISSN 0300-9572, [link] Scott Weingart, MD FCCM. AP placement was proven to be capture at a lower current than the AL placement in the same patients, thus more effective. [5] EMCrit 310 – Transvenous Pacemakers.

Advances Cardiac Life Support (ACLS) 88

Advances Cardiac Life Support (ACLS) CPR Burns Resuscitation 88

Don't Forget the Bubbles

JULY 31, 2023

2004) Positive end expiratory pressure during resuscitation of premature lambs rapidly improves blood gases without adversely affecting arterial pressure. The author reviewed this article after having a burning desire to question where the guidance came from! Probyn, M.E., Hooper, S.B., Dargaville, P.A., McCallion, N., Crossley, K.,

Rapid Diagnostic Testing 98

Rapid Diagnostic Testing Resuscitation Emergency Department Pediatrics 98

Taming the SRU

JANUARY 1, 2024

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. Contraindications for USGIV are the same as for any PIV: overlying skin infection, AV fistula in the extremity, previous surgery impacting vasculature, proximal trauma, or burns.

Emergency Department 90

Emergency Department Ultrasounds Administration Burns 90

RebelEM

AUGUST 7, 2023

This helps relieve agitation/pain while maintaining spontaneous breathing and airway reflexes allowing for adequate pre-oxygenation as well as facilitates other resuscitation interventions including IV access, vasopressors, fluids, etc. that would not be possible in an agitated/combative patient.

Head Injuries 97

Head Injuries Airway Management Outcomes Burns 97

EB Medicine

NOVEMBER 1, 2018

Thankfully, that gentleman was successfully resuscitated despite no bystander CPR, and if you listen carefully, we hope to arm you with the tools to do so similarly. Nachi: Each year, in the US, approximately 10,000 patients present with electrical burns or shocks. Most electrical injuries present with burns to the skin.

Emergency Department 40

Emergency Department Burns EKG/ECG Shock 40

ACEP Now

AUGUST 15, 2023

You may be ruminating on the unsuccessful resuscitation of a cardiac arrest in a young mother, all the notes to be done, or the dread of possibly missing something on the patients you signed out or discharged. The senior nurse who was the key lead in a resuscitation when you were occupied with a crash femoral central line.

Emergency Department 90

Emergency Department Military Resuscitation Wellness 90

Dr. Smith's ECG Blog

DECEMBER 23, 2014

An otherwise health male in his early 40's presented with "burning" in his epigastrium that radiated to his throat and was relieved with Maalox and lidocaine. Here is his post resuscitation ECG: Now the diagnosis is obvious. He had an ECG recorded: Sinus Rhythm. This was read as normal by the emergency physician and by the computer.

EKG/ECG 52

EKG/ECG Burns Resuscitation Outcomes 52

PHEM Cast

MARCH 17, 2016

References Wilmalasena Y, Burns B, Reid C, Ware S., Effects of face mask ventilation in apneic patients with a resuscitation ventilator in comparision with a bag-valve-mask. video cast from Emergency Medicine colleagues in the States discussing and demonstrating techniques for optimal bag-valve-mask ventilation. 2016: 28(1); 67-72.

Airway Management 52

Airway Management Burns Emergency Department Resuscitation 52

Emergency Medicine Ireland

JUNE 10, 2024

We’re going to cover a bit of an environmental/tox topic today and look at carbon monoxide poisoning from Oh’s manual chapter 83 on burns. Resuscitate and investigate as you would any sick patient. Resuscitate and investigate as you would any sick patient. Welcome back to the tasty morsels of critical care podcast.

Poisoning 52

Poisoning EMS Burns Shock 52

Northwestern EM Blog

JANUARY 24, 2022

Due to its extremely high morbidity and mortality as well as high healthcare costs, the prompt recognition, diagnosis and resuscitation of shock is key. There is a subset of patients who, despite aggressive conventional resuscitation, have an inadequate hemodynamic response and develop refractory shock. due to inadequate access.

Anaphylaxis 52

Anaphylaxis Shock Sepsis Resuscitation 52

Northwestern EM Blog

FEBRUARY 28, 2022

A truism in resuscitation is to always rule out the easily correctable causes immediately. As your post alludes to, sometimes patients remain hypoxemic despite our usual efforts and refractory hypoxemia can be an intimidating beast when you’ve got a busy ED burning down around you.

Emergency Department 52

Emergency Department Burns Resuscitation Outcomes 52

Rural Doctors Net

AUGUST 30, 2013

The visual confrontation of a man in pain with an obvious amputation and airway burns will induce a catecholamine surge in all but the psychopathic. Whilst we’ve ‘re-discovered’ balanced resuscitation (first described by Cannon back after WWI), there remains some limited controversy – listen to this 2013 take from Simon Carley at St.

Burns 52

Burns Hospitals Wellness Ambulance Services 52

PulmCCM

FEBRUARY 19, 2024

Panelists called this “low certainty evidence from five before-after studies that this intervention may be associated with lower mortality and fewer unsuccessful resuscitation events.” More health care professionals are burned out or disengaged. ” But even that watered-down statement is unjustified.

Hospitals 52

Hospitals Resuscitation Burns Documentation/Coding 52

ACEP Now

OCTOBER 9, 2024

However, the persistence of tachycardia despite fluid resuscitation and dosing with lorazepam to help with his panic disorder raised concerns that warranted further investigation. Burns E, Buttner R. Given his history, it could have been easy to attribute his current presentation to his known mental health conditions. Published 2022.

EKG/ECG 52

EKG/ECG Fluid Resuscitation Ultrasounds Outcomes 52

Pediatric Emergency Playbook

NOVEMBER 1, 2015

We have a few minutes to optimize, to resuscitate before we intubate. The goal is a good general perfusion and a balanced resuscitation, ensuring enough cerebral perfusion without disrupting nascent clots. She is in respiratory failure from bronchiolitis and likely viral sepsis. She needs her airway taken over.

Shock 40

Shock Sepsis Airway Management Pediatrics 40

Pediatric Emergency Playbook

OCTOBER 1, 2015

The Huber needle is not a resuscitative line. Increased demand may be temporary, such as in burns, s/p cardiac surgery, or ay prolonged recovery. Vascular Devices: assume the line is not functional, and use another to resuscitate, especially in port-a-caths. He is in compensated shock.

Pediatrics 40

Pediatrics Fractures Resuscitation Burns 40

Don't Forget the Bubbles

AUGUST 14, 2023

Impact of childhood burns on academic performance: a matched population-based cohort study. Factors Associated With Improved Pediatric Resuscitative Care in General Emergency Departments. Eur J Pediatr. 2023 Jul 12. Accurate diagnosis of acute hemorrhagic edema of infancy: a French multicenter observational study. Leducq S, et al.

Pediatrics 52

Pediatrics Hospitals Emergency Department Outcomes 52

ACEP Now

JULY 7, 2023

Otolaryngology (ENT) was emergently consulted and the patient was brought to a resuscitation bay because of worry concerning possible aspiration secondary to posterior epistaxis, requiring further airway stabilization. Burns B, Habig K, Eason H, Ware S. Ann Am Thoracic Soc. 2017;14(3):368-375. 2016;35(1):28-32.

Airway Management 45

Airway Management EMS Burns Operations 45

Northwestern EM Blog

SEPTEMBER 12, 2022

This post will discuss a brief overview of hospital planning and operational setup with key elements of a disaster response from events that cause high numbers of blunt trauma, penetrating trauma, burns or crush injuries that may be seen following explosive events, mass shootings, or large scale motor vehicle collisions, to name a few.

Mass Casualty Incidents 52

Mass Casualty Incidents EMS Hospitals Hazardous Materials 52